Reply to MD Carefirst Gold HMO plan on md exchange

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[quote=Anonymous]I'm about to go through the exact same thing, and it drove me nuts that I couldn't get a straight answer on how things would be charged so I could decide between the Gold 1,000 and Gold 1,750 plan. Here's my educated guess as to what happens: The monitoring stuff (ultrasound, bloodwork) is straight copays, which don't apply to your deductible. Things like egg retrieval and transfer are done at a location that considers itself to be an ambulatory surgical center (at least, I think this is the case for Shady Grove Fertility but I couldn't get a straight answer from them). As long as it's not considered a [u]hospital[/u] facility, there's a $300 copay for the facility, plus copays for things like anesthesia and the doctor/surgeon (which again none of these apply to the deductible). So it may be that the total costs end up being around the total deductible amount, but the payments weren't actually being applied to your deductible. If that is the case, then it's a better deal to have the 1750 plan since you have a smaller deductible for meds ($150 instead of $1k).

On a side note, I think it's lazy of them to just say to pay them the deductible. Why don't they bill you as you go along for exact amounts, or goodness know they have a lot of people getting IVF done through the Maryland CareFirst plan, so why don't they just add up the amounts based on experience and give you a more accurate estimate?! Anyway, I hope that helps and hopefully the getting a refund part won't be too difficult![/quote]

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